Overview Information

Red yeast is the product of rice fermented with a type of mold. People use red yeast as medicine.

Red yeast is taken by mouth to maintain desirable cholesterol levels in healthy people and reduce cholesterol in people with high cholesterol.

In foods, red yeast is used as a food coloring for Peking duck.

The active ingredient in red yeast is the same as the active ingredient in prescription drugs called statins. Statins are used for high cholesterol. That's why red yeast has all the same possible side effects, drug interactions, and precautions as statins. You should talk with your healthcare provider if you plan to take red yeast.

You may have come across a red yeast product called Cholestin, manufactured by Pharmanex. It was one of the most widely studied red yeast products. Originally, Cholestin contained the same active ingredient found in statin drugs. This caused the U.S. Food and Drug Administration (FDA) to call Cholestin an unapproved drug. Cholestin was reformulated so that its active ingredient is now something else.

How does it work?

Red yeast supplements are made by growing a certain type of mold on rice in a controlled growing environment to allow high levels of the active ingredients to be formed. These active ingredients are similar to the prescription drugs known as "statins."

Uses & Effectiveness?

Likely Effective for

High cholesterol. Research shows that taking red yeast products for up to 6 months can lower total cholesterol, low-density lipoprotein (LDL or "bad") cholesterol, and triglycerides. But these red yeast products contain a chemical that is similar to "statin" drugs such as lovastatin. Statins are approved by the U.S. Food and Drug Administration (FDA) to lower cholesterol. The FDA considers red yeast products that contain statins to be illegal unapproved drugs. But outside the U.S., red yeast products that contain statins are still available. Some red yeast products available in the U.S. contain little or no statins. It is not known if these red yeast products do much to reduce cholesterol levels in people with high cholesterol.

Possibly Effective for

Heart disease. Taking 1.2 grams of red yeast extract daily for an average of 4.5 years decreases the risk of heart attacks and death in people with a history of heart attack.

High cholesterol and triglyceride levels in people with HIV infection. Taking red yeast by mouth seems to reduce cholesterol and triglyceride levels in people with HIV infection.

Possibly Ineffective for

Insufficient Evidence for

Cancer. Some clinical research shows that taking 1.2 grams of red yeast daily for about 4.5 years reduces the risk of dying from cancer by 22% to 56%. But it's not known if red yeast reduces the risk of developing cancer.

Diabetes. Some early research shows that taking 600 mg of red yeast daily for 8 weeks can lower total cholesterol, triglycerides, and blood sugar in people with diabetes. Other early research shows that taking 600 mg of red yeast twice per day for 12 weeks reduces low-density lipoprotein (LDL or "bad") cholesterol and triglycerides, as well as increases high-density lipoprotein (HDL or "good") cholesterol in people with diabetes and liver disease.

Liver disease not caused by alcohol use. Some research shows that taking 600 mg of red yeast twice per day for 12 weeks reduces levels of liver enzymes associated with liver damage and improves levels of blood fats in people with diabetes and a certain type of liver disease not caused by alcohol use.

Diarrhea.

Improving blood circulation.

Indigestion.

Spleen and stomach problems.

Other conditions.

More evidence is needed to rate the effectiveness of red yeast for these uses.

Side Effects & Safety

Red yeast is POSSIBLY SAFE for most people when taken by mouth for up to 4.5 years.

Red yeast contains chemicals similar to the prescription drugs called "statins." Therefore, red yeast might also cause side effects similar to statin drugs, such as liver damage and severe muscle pain and muscle damage.

There is also concern about product quality. Many red yeast products have been found to have different amounts of the statin-like chemicals. Some products may contain none and others may contain high amounts, which are more likely to cause serious side effects.

Serious allergic reactions can occur after breathing in red yeast.

Red yeast that is not fermented correctly may contain citrinin. Citrinin is a poison that may cause kidney damage.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Red yeast is LIKELY UNSAFE when taken by mouth during pregnancy. It has caused birth defects in animals. Not enough is known about the safety of using red yeast during breast-feeding. Don't use during pregnancy or breast-feeding.

Liver problems: Red yeast contains chemicals that are the same as the statin drug lovastatin. Lovastatin can cause liver damage. Some research shows that red yeast might also cause liver damage to the same degree as statin. However, other research shows that red yeast might not cause liver problems and might improve liver function in people with certain liver problems. Because of the mixed results, red yeast products should be used cautiously or avoided in people with liver problems.

Interactions?

Moderate Interaction

Be cautious with this combination

!

Alcohol interacts with RED YEAST

Drinking alcohol might harm the liver. Red yeast might also harm the liver. Taking red yeast along with alcohol might increase the risk of liver damage. Do not drink alcohol if you are taking red yeast.

Gemfibrozil (Lopid) can affect the muscles. Red yeast can also affect the muscles. Taking gemfibrozil along with red yeast might increase the risk of muscle problems.

Medications that can harm the liver (Hepatotoxic drugs) interacts with RED YEAST

Red yeast contains the statin drug lovastatin. Lovastatin might harm the liver in some people. Taking red yeast along with other medications that might also harm the liver might increase the risk of liver damage. Do not take red yeast if you are taking another medication that can harm the liver.<br /><br />
Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.

Medications that decrease the break down of other medications in the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors) interacts with RED YEAST

Some medications are changed and broken down by the liver.<br /><br />
Some medications might decrease how quickly the liver breaks down red yeast. Taking red yeast along with some medications that decrease the breakdown of other medications in the liver can increase the effects and side effects of red yeast. Before taking red yeast, talk to your healthcare provider if you are taking any medications that are changed by the liver.<br /><br />
Some medications that might decrease how quickly the liver breaks down red yeast include amiodarone (Cordarone), clarithromycin (Biaxin), diltiazem (Cardizem), erythromycin (E-mycin, Erythrocin), indinavir (Crixivan), ritonavir (Norvir), saquinavir (Fortovase, Invirase), and many others.

Medications used for lowering cholesterol (Statins) interacts with RED YEAST

Red yeast can help lower cholesterol. Taking red yeast along with other medications used to lower cholesterol might increase the risk of adverse effects. Do not take red yeast if you are already taking medications used for lowering cholesterol.<br /><br />
Some medications used for high cholesterol include cerivastatin (Baycol), atorvastatin (Lipitor), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and others.

Niacin interacts with RED YEAST

Niacin can affect the muscles. Red yeast can also affect the muscles. Taking niacin along with red yeast might increase the risk of muscle problems.

Dosing

The following doses have been studied in scientific research:

ADULT

BY MOUTH:

High cholesterol: 1200 mg to 2400 mg of red yeast once or twice daily for up to 24 weeks. Only products containing chemicals similar to the prescription "statin" cholesterol drugs have been shown to lower cholesterol levels. Many of these products provide approximately 5-10 mg of the statin drug called lovastatin and may contain other ingredients. These products have included Cholestin (non-US, Pharmanex), Xuezhikang (Beijing WBL Peking University Biotech Co.), HypoCol (AsiaPharm Biotech), Zhibituo, and Red Yeast Rice (Sylvan Bioproducts). Red yeast products containing statins are considered illegal in the U.S.

Lu, G. and Gong, L. The comparison of hypolipidemic effects of Xue-Zhi-Kang and simvastatin on patients with hypercholesterolemia. Scientific Report Number PN0134

Lu, Z. L., Xu, S., and Kou, W. R. The clinical observation of treatment of hyperlipidemia with different dose of Xuezhikang. National Symposium of Clinical Therapies for Cardiovascular Diseases 1995;1997:53-57.

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CONDITIONS OF USE AND IMPORTANT INFORMATION:
This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.